{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Jane A Orr","gend":1,"currentgend":"","add":"48 BUTLER ST","city":"SOUTH BERWICK","state":"ME","zip":"03908","dob":"1950-02-07","age":"","mstatus":"","insh":"10000057527","cliId":"","pno":"6178036485","cno":"","email":"5jaorr0@gmail.com","ename":"","eno":"","pphy":"JOKONYA, CHIEDZA","ppno":"2073844949","pcpadd":"789 CENTRAL AVE,","pcpcity":"DOVER","pcpstate":"NH","pcpzip":"38202526","pcpcounty":"","pcpid":"","pcpname":"WHP SOUTH BERWICK FAMILY PRACTICE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"48 BUTLER ST","madd2":"","madd3":"","mcity":"SOUTH BERWICK","mstate":"ME","mzip":"03908","pcpfaxno":"2073845700","pcpnpi":"1043314313","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5U84V39MK85","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L814","D229","L821","Z7189","N952","S0006XA","W57XXXA","E1042","Z9641","E109","Z794","E1049","L84","Z1231","E119","H40023","H25813","H04123","H5213","H524","E1036","D485","Z0000","G8929","M25552","M5450","R5381","M1612","M5136","R29818","D1800","R200","E1065","G9389","R42","G939","Q283","Q898","R202","Z7409","R489","T380X5A","I10","F32A","E785","I951","D1802","K5900","H532","M6281","H50011","H5021","I69998","Z23","R2681","R209","H4912","H539","R6889","R059","R509","Z8673","M2041","M2042","H25043","D2272","H401131","Z01419","Z779","H40053","R269","I493","I6523","E876","N390","K529","R270","I6900","R1310","I629","I613","J9811","G936","I2699","R29898","R609","I639","R490","J189","R9431","F338","Z789","Z743","R1312","J9601","I619","E162","R82998","K5100","S199XXA","S0990XA","R197","S31831A","I771","Z98890","J9690","I615","E8351","R918","J90","Z4682","R0602","C069","R443","R410","H52223","R350","J302","I63541","R4182","G527","Z9911","I69291","R531","J383","I2694","H25812","H353131","H25811","M79605","M79604","R519","S31631A","I69354","G9009","G9001","S12041A","I7774","M4802","M47812","H25819","Z139","I69398","Z79899","Z022","M8088XA","R000","E118","R300","R739","I959","Z0389","M542","R195","Q282","T17908A","S12000A","Z9981","S12001A","W06XXXA","A4151","A4152","S12030D","G919","Z86711","I119","N898"],"date":["2024-05-08","2023-04-17","2024-05-08","2024-05-08","2023-04-18","2023-04-27","2025-03-28","2026-01-29","2025-07-29","2025-12-24","2025-07-29","2025-03-04","2025-03-04","2024-05-28","2025-03-14","2024-03-12","2024-07-12","2024-03-12","2025-12-18","2025-01-07","2024-05-01","2023-07-24","2023-07-20","2023-07-20","2023-07-25","2023-07-20","2025-06-16","2023-07-25","2023-07-25","2023-08-08","2023-08-10","2023-09-01","2026-02-05","2026-02-17","2025-08-01","2025-05-19","2025-10-09","2023-08-10","2023-08-10","2025-09-12","2023-08-29","2023-08-11","2026-01-29","2025-07-17","2025-07-15","2023-08-17","2023-08-10","2026-02-11","2025-05-13","2026-02-10","2023-09-19","2023-09-19","2023-09-01","2023-10-17","2023-11-01","2023-10-24","2024-03-12","2026-02-03","2023-11-09","2023-12-02","2025-09-08","2025-09-12","2025-03-04","2025-03-04","2024-03-12","2024-05-08","2025-09-30","2024-06-03","2024-06-03","2025-03-14","2026-01-07","2025-09-11","2025-05-12","2025-09-11","2025-12-30","2025-09-11","2026-02-16","2026-02-16","2025-09-03","2025-07-21","2025-05-21","2025-06-06","2025-05-18","2025-05-27","2025-05-24","2025-05-30","2025-05-27","2025-12-08","2025-05-23","2025-09-09","2026-02-05","2025-05-30","2025-08-05","2025-05-22","2025-05-22","2025-05-12","2025-06-30","2025-12-23","2025-09-08","2025-09-08","2025-09-08","2025-11-11","2025-09-08","2025-05-23","2025-05-21","2025-05-22","2025-05-19","2025-09-09","2025-05-18","2025-06-06","2025-05-13","2025-05-27","2025-05-18","2025-09-08","2025-09-08","2025-01-07","2025-07-07","2025-07-07","2025-05-26","2025-09-12","2025-05-21","2025-05-21","2025-07-21","2025-09-12","2025-05-15","2025-05-21","2025-03-31","2025-03-31","2025-03-31","2025-08-02","2025-08-02","2025-08-01","2025-03-28","2025-07-17","2025-07-01","2025-06-26","2025-08-01","2025-08-01","2025-08-02","2025-08-02","2025-03-14","2025-12-03","2025-06-06","2025-06-07","2025-06-07","2025-08-01","2025-06-01","2025-06-27","2025-07-26","2025-06-16","2025-06-16","2025-06-03","2025-08-01","2025-11-11","2025-05-21","2025-05-30","2025-08-01","2025-08-01","2025-08-01","2025-08-01","2025-06-24","2025-06-19","2025-11-05","2025-05-29","2025-07-15","2025-06-12","2023-03-07"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},{"a":[]}]},{"t":"COVID Screening","q":[{"a":[]},{"a":[]},{"a":[]}]},{"t":"Self-Assessment and Social History (SDOH)","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Activities of Daily Living","q":[{"a":[]}]},{"t":"Medical History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Family History","q":[{"a":[]}]},{"t":"Preventive Care","q":[{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","","Estradiol 0.01 % Vag Cream Mylan","","","Select","Select",""],["","","FLUTICASONE PROP","50 MCG","","Select","Select",""],["","","Bd Nano 2 Gen","","","Select","Select",""],["","","CITALOPRAM","20 MG","","Select","Select",""],["","","GLUCAGON EMERGENCY KIT","","","Select","Select",""],["","","LISINOPRIL","5 MG","","Select","Select",""],["","","RISEDRONATE SODIUM","","","Select","Select",""],["","","CAPTOPRIL","12.5 MG","","Select","Select",""],["","","ZEGALOGUE","","","Select","Select",""],["","","MNEXSPIKE","","","Select","Select",""],["","","RISEDRONATE","150 MG","","Select","Select",""],["","","LOPERAMIDE","2 MG","","Select","Select",""],["","","CAPVAXIVE","","","Select","Select",""],["","","FLUZONE HIGH-DOSE","","","Select","Select",""],["","","BUDESONIDE","3 MG","","Select","Select",""],["","","Estradiol 0.01 % Vag Cream Padagis","","","Select","Select",""],["","","SIMVASTATIN","10 MG","","Select","Select",""],["","","LEVETIRACETAM","500 MG","","Select","Select",""],["","","PFIZER-BIONTECH GRAY","","","Select","Select",""],["","","TOLTERODINE","2 MG","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","CEPHALEXIN","500 MG","","Select","Select",""],["","","FLUAD","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","ALBUTEROL HFA","90 MCG","","Select","Select",""],["","","MELOXICAM","7.5 MG","","Select","Select",""],["","","Latanoprost 0.005 % Ophth Sol Greenstone","","","Select","Select",""],["","","CONTOUR NEXT","","","Select","Select",""],["","","B-D ULTRA-FINE SHORT","","","Select","Select",""],["","","NITROFURANTOIN MACRO\/MONO","100 MG","","Select","Select",""],["","","LANTUS SOLOSTAR","","","Select","Select",""],["","","Comirnaty 2023-2024","","","Select","Select",""],["","","GVOKE HYPOPEN","","","Select","Select",""],["","","QUETIAPINE","25 MG","","Select","Select",""],["","","DICLOFENAC SOD","75 MG","","Select","Select",""],["","","COMIRNATY","","","Select","Select",""],["","","Clobetasol 0.05 % Ointment Encube","","","Select","Select",""],["","","BASAGLAR KWIKPEN","","","Select","Select",""],["","","SULFAMETHOXAZOLE\/TRIMETHOPRIM","800\/160 MG","","Select","Select",""],["","","IBANDRONATE","150 MG","","Select","Select",""],["","","NOVOLOG","","","Select","Select",""],["","","ADMELOG SOLOSTAR","","","Select","Select",""],["","","Novolin N Flexpen","","","Select","Select",""],["","","Latanoprost 0.005 % Ophth Sol Somerset","","","Select","Select",""],["","","Latanoprost 0.005 % Ophth Sol Sandoz","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","100 MG","","Select","Select",""],["","","LEVEMIR FLEXTOUCH","","","Select","Select",""],["","","Insulin Aspart 100 Units\/Ml Inj Nordisk","","","Select","Select",""],["","","LATANOPROST","0.00005","","Select","Select",""],["","","ESTRADIOL","0.0001","","Select","Select",""],["","","BD NANO","","","Select","Select",""],["","","INSULIN ASPART","100 UNITS\/ML","","Select","Select",""],["","","CLOBETASOL","0.0005","","Select","Select",""]]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Assessment of Diagnoses","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"a":[]},{"a":[]}]},{"t":"Home Safety & Personal Goals","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"","a10":[],"a11":"","a12":"","a13":""}]}]}